Wisconsin Rural Hospital Flexibility Program
-- Critical Access Hospitals
PDF Version
of BQA 00-049 (PDF, 10 KB)
Introduction | Rules_&_Regulations
| Forms | Providers | Contacts | What's_Happening
| Publications | Related
Sites
Date: June 26, 2000 DSL-BQA
00-049
To: Hospitals HOSP 22
From: Jan Eakins, Chief, Provider Regulation and
Quality Improvement Section
via: Susan Schroeder, Director, Bureau of Quality
Assurance
The purpose of this memorandum is to inform you of language in the
federal Balanced Budget Refinement Act of 1999 (BBRA-99) (Public Law 106-113) that affects
Chapter DHS 124 (exit DHS), Wis. Adm. Code - Hospitals, Subchapter VI - Critical Access
Hospitals (CAH). The BBRA-99 includes amendments that expand the eligibility conditions
under which certain hospitals may apply for a CAH status. It also redefines the 96-hour
inpatient stay limits for existing CAHs. These amendments are described below.
Department will integrate the BBRA-99 additions and amendments as other revisions are
made to Chapter HFS 124. During the interim, the Department will implement the BBRA-99
changes by incorporating them into the CAH application materials and as a directive to
existing CAHs. The effective date of the BBRA-99 changes is January 1, 2000.
-
Under the BBRA-99, rural for-profit hospitals, meeting the Wisconsin Rural
Health Plan, and the "Potential Pool of Applicants" selection criteria, may
now enter the application processes for a Critical Access Hospital (CAH) certification.
-
A hospital that was closed within ten years before the effective date of the BBRA-99 may
apply for a CAH status if the Department approves that it can operate as a hospital under
HFS Chapter 124. In addition, the hospital applicant must meet the Wisconsin Rural
Health Plan, and the "Potential Pool of Applicants" selection criteria
before proceeding with the application process.
-
The BBRA-99 permits reclassification of certain urban hospitals—located in
metropolitan statistical areas—as rural hospitals, as defined in section 1886(d)(8)
of the Social Security Act (42 U.S.C. 1395ww(d)(8)). A Wisconsin hospital located in an
urban county may apply for Critical Access Hospital status if it satisfies any of the
below-listed federal conditions, the Wisconsin Rural Health Plan, and the
"Potential Pool of Applicants" selection criteria.
"(I) The hospital is located in a rural census tract of
a metropolitan statistical area (as determined under the most recent modification of the
Goldsmith Modification, originally published in the Federal Register on February
27, 1992 (57 Fed. Reg. 6725))."
Under this methodology, two Wisconsin counties qualify: Douglas and
Marathon.
"(II) The hospital is located in an area designated by
law or regulation of such State as a rural area (or is designated by such State as a rural
hospital)."
A rural area is defined in Section 231.35(1)(d), Wisconsin Statute as
follows: "Rural" means outside a metropolitan statistical area specified under
42 CFR 412.62 (ii)(A) or in a city, village or town with a population of not more
than 14,000.
"(III) The hospital would qualify as a rural, regional,
or national referral center under paragraph (5)(C) or as a sole community hospital under
paragraph (5)(D) if the rural hospital were located in a rural area."
-
A hospital operating as a CAH must limit the length of stay for acute care inpatients
not to exceed an annual average of 96-hours per inpatient. This requires that the
hospital establish a system for recording inpatient length-of-stay data to determine: (1)
the annual average length of stay (LOS) for each inpatient, and (2) to track, on a
periodic basis, the LOS pattern to ensure that the annual 96-hour average is not exceeded.
If you have any questions about the above BBRA-99 amendments, please contact Lillian
Redding, Project Director of the Wisconsin Rural Hospital Flexibility
Program [retired, contact Jean Kollasch, (608) 267-0466].
PDF: The free Acrobat Reader®
software is needed to view and print portable document format (PDF) files.
Learn more.
|
